Volcanic Disruption

[Trayos]

As most of you are aware, the continuous eruption of Eyjafjallajokul from April 14th onward had disrupted air traffic across most of Europe. While the initial cloud has dissipated enough for mainland European aircraft to take flight, there is a new ash cloud which has caused ireland to close its airspace, which could be a sign of another disruption over europe. The current situation can be observed here (Click on layers, then Volcano Ashes Layer
As always, the worries about Katla, a neighboring (and much more powerful) volcano being triggered are actively being spread.

Norway has already relocated its entire HEMS/FWEMS capacity to ground operations (and not reopened it of yet). The question I pose is this:
A.What scenarios should EMS personnel in affected/at risk areas be conscious of? Taking into account stranded persons, weather conditions, and possible hysteria, what should be done to prepare in the even the ash cloud increases/Katla erupts?
B. Are there any people who can elaborate on the situation regarding EMS air transport in other north European countries?

 

[usafmedic45]

B. Are there any people who can elaborate on the situation regarding EMS air transport in other north European countries?

You simply handle the transport issues like you do when there is a prolonged period of bad weather. It is not that huge of an issue from a medical standpoint and does not require any drastic measures for rectification. The Scandinavian nations probably have their crap together better in regards to both prehospital care in general and dealing with the effects of aeromedical transport being not an option than anyone else on the planet. The loss of air transport is not going to be that big of a problem other than all the people stranded because of cancelled flights.

A.What scenarios should EMS personnel in affected/at risk areas be conscious of? Taking into account stranded persons, weather conditions, and possible hysteria, what should be done to prepare in the even the ash cloud increases/Katla erupts?

The only potentially serious health hazard is the pulmonary effects of the inhalation of the ash (pneumoconiosis: http://en.wikipedia.org/wiki/Pneumoconiosis; alternatively known as "Pneumonoultramicroscopicsilicovolcanoconiosis" http://en.wikipedia.org/wiki/Pneumonoultramicroscopicsilicovolcanoconiosis which is one of the longest words in the English language but is not used clinically), although this is going to be a problem mostly in Iceland as the severity of problems is proportional to the concentration of the ash in the atmosphere (for the most part). The other health effects are going to be only seen in the areas immediately surrounding the volcano (eye irritation, etc).

 

[LucidResq]

Volcanoes and You!

Pyroclastic flows account for most fatalities associated with volcanoes

Debris from such flows can be hurled enough to cause severe secondary blast injuries. Severe/fatal burns are also possible. (I'm not in the know enough about Katla to know what, if any, population is in the vicinity, but flows often extend 15-25 km)

Tephra (essentially a fancy word for ash and some larger sized fragments) can accumulate in great depth (several meters)

There is actually very little research on the effect that volcanic ash has on the respiratory system.

Acute silicosis has been a primarily theoretical concern for ash that has high silica and cristobalite content, but when studied, no cases were reported with two eruptions that dispersed ash of this quality: Mount St. Helens and Soufriere, Montserrat.

However, these studies did show that during the Mount St. Helens eruption, there was a doubling of emergency room visits for asthma and bronchitis related visits compared to the previous year. Increased bronchial reactivity and wheeze in children were observed in the Montserrat eruption.

The amount of total suspended particles (TSP) present is a predictor for ED visits for respiratory complaints during/after a volcanic event, especially for asthmatic patients. Visits peaked around 30,000 microgram per cubic meter in Mount St. Helens. Rain significantly decreases TSP.

Volcanic gases are another concern.... carbon dioxide, sulfur dioxide, hydrogen fluoride are usually released in small amounts but can accumulate in higher levels and cause problems. Emissions spectrums are useful to determine if these gases are present and to what degree.

Remember that eruptions can be related with tsunamis and earthquakes. Ash clouds can generate lightning strikes as well and have caused electrocution injuries in the past.

Majority of deaths occur within 24 hours of a volcanic event. Hospitals in fallout areas or other spots with history of dangerous mudslides etc should probably be evacuated.

Pre-incident... hospitals and responders can benefit from detectors for the aforementioned gases, definitely would have N-95 respirators on hand and encourage their use.

Know where pyroclastic flows have occured in the past and avoid them (duh)... typically low-lying areas. Because of toxic gases, avoid basement, cellars, depressions, etc until air quality has been tested. Accumulation of ash can cause building collapse. It may need to be cleared or buildings may need to be evacuated.



***Jay G. Volcanic eruption. In: Ciottone GR, Darling RG, Anderson PD, Jacoby I, Noji E, Suner S, et al, editors. Disaster medicine. 3rd ed. Philadelphia: Mosby Elsevier; 2006.

Baxter PJ, Ing R, Falk H, Plikaytis B. Mount St. Helens eruptions: the acute respiratory effects of volcanic ash in a North American community. Arch Environ Health. 1983;38(3):138-43.

Newhall CG, Fruchter JS. Volcanic activity: a review for health professionals. Am J Public Health. 1986;76(3 Suppl):10-24.

Simkin T, Sibert L, Blong R. Disasters: volcanic fatalities - lessons from the historical record. Science. 2001;3:93-109.

 

[firetender]

...and from the middle of Nowhere

I live on Maui, a few hundred nautical miles away from the Southeast corner of Hawaii (the "Big Island"). Mt. Kiluea is erupting now. We're having seasonal shifts of wind coming up from the SE and driving the "VOG" (volcanic-fog) over our island. It hovers so thick it often covers our own two volcanoes (10,000 ft. and 5,600 ft. tall respectively) from view!

This is nothing like what's spewing up north, but I'll tell you this, people all over this island, like myself, are put down by it. They usually talk about the sulpher dioxide levels in the air as the dangerous stuff, but even when the levels are relatively low and when you can literally see the air gray with particulate matter, LOOKOUT, Boy...it sucks!

 

[Trayos]

The last time Katla had a major eruption event, in 1918, glacier runs with house-sized icebergs swept away residents, and extended the southern shore of Iceland by a 5 km spit, in an area where the sea depth was estimated between 2000 and 3000 fathoms.

And in the 1755 Katla eruption, the volume of floodwaters from the Myrdalsjökull glacier were estimated to be equal to or greater than the discharge of water from the Amazon, Nile, and Mississippi Rivers combined.

http://www.csmonitor.com/Science/20...kull-volcano-is-nothing-to-Angry-Sister-Katla

It would also have further international effects (although we have evolved quite a bit since the 1700's)

The winter was one of the longest and coldest on record in North America. New England reported a record stretch of below-zero temperatures and New Jersey reported record snow accumulation. The Mississippi River also reportedly froze in New Orleans.

http://www.usatoday.com/tech/science/2010-03-22-iceland-volcano_N.htm?csp=obinsite

In a worst case scenario, Laki, another volcano on this shelf, could erupt. However, Katla is at a much higher risk of eruption. If it experienced an event such as Laki did in 1783 (even with much less intensity, due to the fact it is only a good 20 years overdue)

Researchers found that Iceland's Laki volcanic event, a series of about ten eruptions from June 1783 through February 1784, significantly changed atmospheric circulations across much of the Northern Hemisphere. This created unusual temperature and precipitation patterns that peaked in the summer of 1783, including far below normal rainfall over much of the Nile River
watershed and record low river levels.

http://www.nasa.gov/centers/goddard/news/topstory/2006/volcano_nile.html

The poisonous basaltic gases expelled from Laki drifted over europe, and caused mass crop failure and widespread poisoning in northern UK.

Katla has the whole range of magmatic compositions from basalt to rhyolite, which are richer in silica. However, the effect of these gases in the years following their release into the atmosphere are much more complex than just straight cooling.

http://www.accuweather.com/blogs/news/story/30707/explosive-katla-could-affect-g.asp

What personally raised the issue for me was this announcement by Icelands President:

the time for Katla to erupt is coming close ... we [Iceland] have prepared ... it is high time for European governments and airline authorities all over the world to start planning for the eventual Katla eruption

http://news.bbc.co.uk/2/hi/programmes/newsnight/8631343.stm

If a government would risk increased hysteria by announcing such information to the global community, it is fair to assume that they have information to back it up.
Thus, this raises the question of how Northern Europe would react to larger amounts of more health-damaging silica, compounded by slight temperature changes and larger dispersion.

In terms of direct effect, there is no major human population directly in the 25 km radius- major icelandic towns are well over 90 km away.